North Macedonia
Country Programmes

Working bottom up – building a local model for deinstitutionalization

Start DateOngoingEnd Date
29 May 201831 Dec 2020
Programme Status
Programme Budget
US$ 383,490
Thematic focus: Access to Health, Awareness Raising, Employment, Inclusive education, Independent Living, Social Protection

Implementing Partners

UN Agencies

  • UN Women
  • UNDP

Government Organizations

  • Ministry of Labor and Social Policy
  • Ministry of Education and Sciences
  • Ministry of Health
  • Institute of Social Activities
  • State Education Inspectorate
  • Center for Social Work
  • Regional Employment Center

Organizations of Persons with Disabilities

  • Organizations of Persons with Disabilities of Strumica region
  • Organizations of Women with Disabilities

The Programme

The UN country team took a two-pronged approach to ensuring that persons with disabilities can realize their right to live independently and be included in the community. First, a localized pilot program focused on the Banja Bansko institution and the surrounding Strumica region will demonstrate that community-based options are a feasible, affordable way to facilitate independent living. Second, a national effort to support biological and foster families will prevent further institutionalization of children with disabilities.


The localized pilot program deliberately targeted a single institution in a single region. This is because top-down legislation and policies have failed, over decades, to enable persons with disabilities to realize their rights in everyday practice.
The UN team worked jointly at the local level to create a successful model of community services covering all areas – education, healthcare, housing, employment – that can then be replicated more widely.
This approach has been welcomed by the responsible national institutions, making the prospects for sustainability and nationwide implementation far better than in the past. While localized deinstitutionalization was the aim of the first effort, halting the practice of confining children with disabilities to institutions was the goal of the second.
The UN team provided rights-based, gender-sensitive training to the full range of professionals who work with persons with disabilities, while also working directly with persons with disabilities (and their associations) to build the skills needed to exercise their rights and take a decisive say in the design and provision of the services they want.

Programme Documents